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ADZ Laboratories, Inc.L-7391( • <br /> 2773 Downhill Drive Steamboat Springs,CO 80487 (800)334-5493 <br /> Name: Ainsley Stewart Address: 131 E.Lincoln Ave Ste.200 <br /> Company: Ensero Solutions Fort Collins,CO 80524 <br /> E-mail: astewart@ensero.com Telephone: 867-668-6463,ext 229 <br /> Copy of Report to: <br /> Name: Nate Lambert [E�-mafl: nlambert@ensero.com <br /> company: Ensero Solutions ele none: 303-588-1649 <br /> Name: Pauline Wong Address: 131 E.Lincoln Ave Ste.200 <br /> company: Ensero Solutions Fort Collins,CO 80524 <br /> E-mail: ap@ensero.com Telephone: 778-404-1182 <br /> If samples)received past holding time(HT),or it Insufficient HT remains to complete YES <br /> analysis before expiration,shall ACZ proceed with requested short HT analyses? NO rM <br /> '110-Mwi ACZ wa tord e!c11n11 M Iuew Ynhue'e.n.N-ffl—"YEf—"W N.Nndk.t.d,ACZ wry Pad rO th.r.*—tad tn.lp...—N Nr r.xpk d,-d d.N we a q..N%d <br /> Are samples for SDWA Compliance Monitoring? YesLM No <br /> B yes,please include state forms.Res* will be reported to PQL for Colorado. <br /> Sampler's Name:Tyler F. s Site Information State CO Zip code 80401 Time Zone MTN <br /> '1.ILorte dl..udmNldq ald v.IdLLr dtl,Y nmpla 1.Id.R.11d dl.t Ytbntleniy IIIYrhdleUle tlm./d.e/Imtl.n x <br /> 'Sampler's Signature: w.p.toe.emn.,.�N.r,.w.r,ro ..dn,.d.Ndo�rr.rrNwa.nN,. <br /> PROJECT INFORMATION <br /> Quote#: Ensero-2020 C <br /> Pon: 3100-PO205 = d m v <br /> Reporting state for compliance testing: CO — p to In a <br /> CDar <br /> Check box If samples include NRC licensed material? © w a CL p <br /> • •• a to m 0UD IPT-zw, -G4-G <br /> rr� ° <br /> e ® ❑ ❑ ❑ ❑ ❑ ❑ <br /> L OR,1 LA I ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ® 1 ❑ ❑ ❑ 1 ❑ ❑ [31 ❑ <br /> 113 <br /> © ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ © ❑ ❑ ❑ ❑ 13 <br /> ❑ © © o o ® ❑❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ 1 ❑ <br /> Matrix SW(Surface Water) GW(Ground Water)-WW(Waste Water)•DW(Drlr*ing Water)•St.(Sludge)•SO(Sol)•OL(Ol)-Other(Speerfy) <br /> Shipped 08Jun2022 <br /> Please also send reports to importer@alexco.ehsdata.com and cbethea@ensero.com <br /> V <br /> 0 <br /> Please refer to ACTs terms&conditions located on the reverse side of this COC. <br /> BY: DATE TIME RECEIVED BY- DATE TIMF <br /> I �Zr <br /> —v <br /> FRMAD050.06.14.14 White-Return with sample. Yellow-Retain for your records. <br /> --L7381 1-220721 1 457 Page 24 of 24 <br />